Active NPI
Jeanna Mastracci
- Obstetrics & Gynecology Nurse Practitioner
- Sterling Heights, MI
National Provider Identifier
1861814220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner
- License
- 4704275270
- Practice address
- 44344 Dequindre Rd
Sterling Heights, MI 48314-1038 - Phone
- (586) 262-5060
- NPI assigned
- Jan 19, 2014
- Last updated
- Apr 26, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | 4704275270 | MI | Primary |
Addresses
Primary practice location
44344 Dequindre Rd
Sterling Heights, MI 48314-1038
Mailing address
44344 Dequindre Rd
Sterling Heights, MI 48314-1038
Phone (586) 262-5060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190308001676 | MI | Order and Referring Only - Nurse Practitioner | 6406195452 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461628800000",
"number": "1861814220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44344 DEQUINDRE RD",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483141038",
"telephone_number": "586-262-5060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44344 DEQUINDRE RD",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483141038",
"telephone_number": "586-262-5060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTRACCI",
"first_name": "JEANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-19",
"last_updated": "2016-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "MI",
"license": "4704275270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.